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Asherman syndrome primarily occurs after a dilation and curettage procedure performed for some other reason. Dilation and curettage have both diagnostic and therapeutic indications. Some of them include the following. Removal of the retained placenta after delivery. Removal of retained products of conception after a miscarriage. For elective first trimester abortions. To remove molar pregnancy. For the evaluation of abnormal uterine bleeding. To remove endometrial polyps. And to obtain endometrial biopsies. In addition to dilation and curettage, some other very rare causes of Asherman syndrome include, severe pelvic infections, schistosomiasis, and genital tuberculosis. Trauma to the basal layer of endometrium in opposing areas within the uterine cavity, triggers inflammation, which leads to the formation of adhesive bands to form from one side of the cavity to the other, as you can see in this picture. Thickness of these bands is highly variable, and they may be spotty in location, or confluent. They are also nonvascular. Many patients with Asherman syndrome may have light or absent menstrual periods. However, some patients might have normal periods depending on the surface area that is affected. Some women will have absent menstruation with severe dysmenorrhea, around the time of the anticipated menstrual period. This is due to the buildup of menstrual blood, as a result of obstruction by the adhesions. Most individuals will also have recurrent miscarriages, and infertility. As far as the diagnosis is concerned, Asherman syndrome should be a differential diagnosis in a woman presenting with amenorrhea and other relevant symptoms. Ultrasound scan and hystero-salpingogram will also provide some clues on adhesive disease. Hysteroscopy is the gold standard test for diagnosing Asherman syndrome. Treatment of Asherman syndrome is hysteroscopy guided adhesiolysis with a curette. Following surgery, patients are given a high dose of oral estrogen, followed by cyclical estrogen and progesterone therapy for 3 months to prevent the re-formation of adhesions. An intra uterine device may also be inserted for the same reason. #ashermansyndrome #medtoday asherman's syndrome,infertility,asherman's syndrome symptoms,ashermans syndrome,ashermans syndrome symptoms,ashermans syndrome treatment